SAN PABLO -- Physicians, nurses and community members fighting to keep Doctors Medical Center open as a full-service hospital said Tuesday they weren't giving up despite a double dose of bad news last week.

The odds are growing longer, however, after a judge denied their injunction request to reinstate services that have recently been reduced and a bill that would have designated DMC a public hospital, allowing it to collect higher reimbursement rates, failed to make it out of the state Legislature.

"Certainly, I'm very disappointed," said Dr. Ellen Morrissey, a kidney specialist at DMC and plaintiff in the injunction suit. "I think that the community deserves better."

Morrissey said she believes the plaintiffs will appeal U.S. District Judge William H. Orrick's decision. She added that many of her patients at DMC require frequent treatment and are frightened by the possibility of DMC closing. "One patient told me he might move away from the area so he could have certain care nearby," she said.

Before cutbacks this summer brought on by an $18 million annual deficit, DMC handled nearly 60 percent of West Contra Costa's emergency ambulance traffic and represented about 80 percent of the region's inpatient capacity, according to a 2011 report commissioned by Contra Costa Health Services. The hospital closed to emergency ambulance traffic on Aug. 7.

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Advocates for DMC have continued pushing to keep the hospital fully operational, even while its directors close units and look for alternatives to a full-service hospital.

"We're beyond that now," said Dr. William Walker, director of Contra Costa Health Services, of hopes to maintain a full hospital. "As much as we'd like to fantasize about keeping the hospital open as a full-service facility -- it's not going to happen."

Walker said the county, along with the West Contra Costa Healthcare District, which runs DMC, is instead studying the feasibility of implementing a satellite emergency department, a model he said would be a first for California.

"There are a number of these departments across the country in suburban areas," Walker said. "In a number of those situations, it's the same, where a hospital has closed and left behind an emergency department."

The idea of a satellite department, or decreases to services at DMC, is unpopular with many who work at the hospital.

Dr. Richard Stern, a 33-year veteran of the hospital and its chief of staff, said he was opposed to any reduction in service and believes that a satellite emergency room is a more dangerous option than just closing the hospital.

"An emergency department with a downsized hospital makes no sense," Stern said. "What happens if somebody who is sick, who needs emergency care -- whether it's a heart attack or acute respiratory failure -- can't be treated by emergency department care alone? If they go to a free-standing department, their care is delayed."

Instead, supporters of keeping DMC full service are looking to the county for salvation. Representatives from the California Nurses Association and National Nurses United plan to hold a rally Wednesday morning in front of the office of Contra Costa County Board of Supervisors Chairwoman Karen Mitchoff, asking her to hold a vote to integrate DMC as a full-service hospital run by Contra Costa Health Services.

Mitchoff said that while she's happy to sit down with union representatives, she and the other supervisors agree that it's not possible for the county to take over DMC because the money isn't there.

An interim report by the Hospital Council of Northern and Central California on the best options for DMC is expected in the next week or two. In the meantime, a bill on Gov. Jerry Brown's desk, if signed, would give DMC $3 million -- enough to stay open a few weeks longer while officials determine exactly what its next iteration will be.